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Pregnancy is safe for breast cancer survivors: Experts

Pregnancy after breast cancer does not increase a woman’s risk of a relapse.

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Breast cancer, the most prevalent cancer among Indian women, cannot deter motherhood, if intervention takes place at the right moment, say health experts. According to them, pregnancy is possible for women survivors of breast cancer — it does not increase risk of recurrence and neither does it cause any harm to the baby.

“Yes, pregnancy is possible for breast cancer patients. Currently there is no reason or evidence to believe that becoming pregnant after treatment for breast cancer can cause any risk to the mother or the baby,” Upasna Saxena, Consultant (Radiation Oncology), at Mumbai’s HCG Cancer Centre, told IANS.

“It is possible for women to continue with their pregnancy even while diagnosed with breast cancer and take treatments tailored to the stage of their pregnancy concurrently. They can go on to deliver healthy babies,” added Kanchan Kaur, Associate Director, Cancer Institute at Medanta in Gurugram.

However, for some even “natural pregnancy is possible,” Kaur stated.

In a striking case from the hospital, Paula, 33, from Rwanda, conceived naturally and delivered a healthy baby five years after she was diagnosed with breast cancer, the doctor said.

Paula was at high risk of developing breast and ovarian cancer in 2013. She completed four years of hormone blockade treatment, which blocks the action of Estrogen Receptor (ER) on breast cancer cells. Pregnancy is not advisable whilst on this treatment.

Although she had her eggs frozen before she started her chemotherapy, she conceived naturally and delivered a healthy baby after the treatment stopped.

In another case from HCG, a patient who was diagnosed with breast cancer at the age of 27 and treated in 2007 opted for breast conservation, against a full masectomy — and delivered a healthy baby boy in 2013.

“Previously, there were concerns over increased risk of cancer recurrence in women who contemplate pregnancy, but it’s good news that studies show no such higher risk in women who conceive as compared to women who do not conceive,” Saxena said.

In yet another case, also from HCG, a patient treated for breast cancer in her late 30s conceived and delivered a healthy baby — but 2.5 years after her treatment. She had a history of seven miscarriages.

“However, it is not a blanket statement for all breast cancer patients. It depends on the age of the patient. And while deciding about pregnancy, it is important to consider and talk to the patient about her age, family size and type of breast cancer (aggressiveness and risk of recurrence),” Saxena noted.

According to a report from the Indian Council of Medical Research (ICMR), India had 14 lakh cancer patients in 2016 and this number is expected to increase.

“Breast cancer is currently the most common cancer among Indian women, both in terms of incidence as well as mortality, with proportional prevalence in younger age-groups being higher than the global average.”

“The age standardised rate is approximately 25.8 per one lakh women and is expected to rise to 35 per one lakh women in 2026,” the report stated.

Pregnancy after breast cancer does not increase a woman’s risk of a relapse.

According to the American Cancer Society, surgery for breast cancer is generally safe in pregnancy while chemotherapy seems to be safe for the baby only if given in the second or third trimester of pregnancy, not in the first trimester.

Other breast cancer treatments, such as hormone therapy, targeted therapy and radiation therapy, are more likely to harm the baby and are usually shunned during pregnancy.

“The risk could be the need for caesarean section, premature baby and low birth weight baby (vis-a-vis women with no history of breast cancer treatment),” Saxena said.

“There is, by no means, any increase in the chances of birth defects or deformities in the baby or increased risk of cancer in the baby (unless it is a cancer due to genetic mutation which can be transmitted to the baby).

“There may be difficulty in breast-feeding post surgery and radiation, but it is still possible with probable lower milk production on the treated side,” Saxena explained.

However, it would be advisable to wait for two years post-treatment to check for an early recurrence.

Kaur suggested that young women diagnosed with breast cancer need to be made aware about the methods to preserve fertility prior to starting treatment.

“Their ova (eggs) can be harvested (as is done for patients undergoing IVF) and preserved for future implantation either in the treated patient or a surrogate,” she explained.

(Rachel V. Thomas can be contacted at [email protected] )

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Covid-19 corollaries on the dairy sector: CRISIL

Overall, demand for milk and dairy products would be lukewarm in the near term, so prices are unlikely to boil over, according to the report.

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New Delhi, May 26 : Supply chain disruptions in the early weeks of the nationwide lockdown, and bread-and-butter issues for hotels, restaurants and cafes, have materially reduced demand for dairy products.

This is despite supply of most dairy products continuing during the lockdown, since they are categorised as essentials.

The shuttering of hotels and dine-ins has also dried up off-take of skimmed milk powder and khoya.

According to report by CRISIL Research on the state of dairy industry and supply chains, products that can’t be made at home easily – such as cheese, flavoured milk and also khoya – haven’t found their way back to the dining table in the same quantities as before the lockdown.

Demand for ice creams, which usually peaks in summer (accounting for 40 per cent of annual sales) has just melted away. Rural areas, which are feeling the income pinch more, seem to be staying off butter and ghee, the report by global analytics firm has said.

To be sure, since the third week of April, supply chains have turned smoother, so demand for staples such as milk, curd, paneer and yogurt are expected to see a quick rebound, leading to on-year expansion in sales, CRISIL said.

The pandemic, however, may sour the business for unorganised dairies because of pervasive contamination fears.

Conversely, as consumers shift, revenues of organised dairies and packaged products should fatten.

Overall, demand for milk and dairy products would be lukewarm in the near term, so prices are unlikely to boil over, according to the report.

Large brands such as Amul and Mother Dairy had already hiked retail milk prices by 4-5 per cent last fiscal. They may not serve an encore.

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445 people died from Australia bushfires smoke: Experts

Melbourne, Sydney and Canberra all had periods where they had the worst air quality in the world as a result of the smoke.

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Arogya Setu App

Canberra, May 26 : Smoke from Australia’s devastating 2019-20 bushfires killed at least 445 people, health experts revealed on Tuesday.

Fay Johnston, a public health expert from the Menzies Institute for Medical Research at the University of Tasmania, told the bushfire royal commission on Tuesday that her team estimated that 445 people died as a result of the smoke that blanketed much of the nation’s east coast, reports Xinhua news agency.

It takes the total death toll from the 2019-2020 bushfire season, which has been dubbed the “Black Summer”, to nearly 480 after 34 people lost their lives directly.

According to modelling produced by Johnston and her colleagues, 80 per cent of Australians were affected by the smoke at some point, including 3,340 people who were hospitalized with heart and lung problems.

“We were able to work out a yearly cost of bushfire smoke for each summer season and… our estimates for the last season were A$2 billion in health costs,” Johnston said.

“There’s fluctuation year to year, of course, but that was a major departure from anything we had seen in the previous 20 years.”

Melbourne, Sydney and Canberra all had periods where they had the worst air quality in the world as a result of the smoke.

Commissioners also heard on Tuesday that the increasing frequency of significant bushfire events in Australia meant that survivors no longer feel safe during the recovery phase.

“Disasters are no longer perceived as rare events, they are often seen as climate change, and they’re part of our new reality,” Lisa Gibbs, a child welfare expert from the University of Melbourne, said.

“We don’t know how that is going to affect recovery because the seeds of hope are a really important part of people’s ability to deal with what has happened and to get back on track.”

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Rising urbanization likely cause of heavy rainfall in South: Research

Their findings were reported in the ‘Quarterly Journal of Royal Meteorological Society’ on May 18, 2020.

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Hyderabad, May 26 : A team of researchers at the University of Hyderabad (UoH) have discovered a link between heavy rainfall in several parts of south India and a growing urbanisation in the region.

A team led by Prof. Karumuri Ashok from the Centre for Earth, Ocean and Atmospheric Sciences of the University of Hyderabad, examined whether a common factor, the changing ‘land use land cover’ (LULC) in these states, has any implications for the heavy rainfall events.

Over the past few years, many heavy rainfall events have been reported in cities of south India. Prominent among them are the extreme rainfall that created havoc in Chennai and nearby areas of Tamil Nadu in December 2015, the heavy rainfall over Hyderabad and adjoining regions in Telangana in September 2016, and the extreme rainfall event in Kerala in August 2018.

Notably, these three states differ in their geographical locations, and also the season in which they receive rainfall. Kerala, located on the southwest Indian coast off the Arabian Sea receives heavy rainfall during the summer monsoon from June-September.

Tamil Nadu, off the Bay of Bengal, receives rainfall mainly during the northeast monsoon (October-December). The land-locked state Telangana receives the bulk of its annual rainfall during the summer monsoon season.

A UoH statement stated that their study showed the precipitation during heavy rainfall events in these states has significantly increased from 2000 to 2017. Using the LULC data from ISRO, and by conducting 2 km resolution simulation experiments of twelve heavy rainfall events over the states, the researchers found distinct LULC changes in these three states, which led to higher surface temperatures and a deeper and moist boundary layer. These in turn caused a relatively higher convective available potential energy and, consequently, heavier rainfall.

The study also suggests that increasing urbanization in Telangana and Tamil Nadu is likely to enhance the rainfall during the heavy rainfall events by 20%-25%. Prof. Ashok feels that improving the density of observational rainfall and other weather parameters may help in forecasting extreme rainfalls at city level.

Their findings were reported in the ‘Quarterly Journal of Royal Meteorological Society’ on May 18, 2020.

Prof. K. Ashok and his Ph.D. student Mr. A. Boyaj who is the first author, are both from the Centre for Earth, Ocean and Atmospheric Sciences of the University of Hyderabad. The work was done in collaboration with Prof. Ibrahim Hoteit and Dr Hari Prasad Dasari of King Abdullah University of Science and Technology (KAUST), Saudi Arabia.

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